Healthcare Provider Details

I. General information

NPI: 1316842545
Provider Name (Legal Business Name): YOUR SAFE HAVEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4606 BERMUDA DUNES DR
PASCO WA
99301-2193
US

IV. Provider business mailing address

4606 BERMUDA DUNES DR
PASCO WA
99301-2193
US

V. Phone/Fax

Practice location:
  • Phone: 509-713-4404
  • Fax:
Mailing address:
  • Phone: 509-713-4404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHELLE K LYNCH
Title or Position: OWNER/OPERATOR
Credential: RN
Phone: 509-713-4404